Thompson Trevor R, Belsito Donald V
Division of Dermatology, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Am J Contact Dermat. 2002 Dec;13(4):177-82. doi: 10.1053/ajcd.2002.36643.
The 1994-1996 North American Contact Dermatitis Group (NACDG) patch test results were the first, since the inception of the NACDG in 1970, to include results from a medium-sized metropolitan city in the Midwest.
The aim of this study was to determine whether the causative allergens of allergic contact dermatitis (ACD) in the Midwest differ from those in other regions of the United States and, if so, whether occupational or other factors account for the observed differences.
Retrospective analyses of patch test data collected at the University of Kansas Medical Center (Kansas City, KS) were compared with the data collected by the other NACDG centers.
Patients in Kansas City were statistically more likely to react to potassium dichromate, formaldehyde and its releasers, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), and glutaraldehyde. Occupational exposures to chromium and formaldehyde were increased significantly among patients from Kansas City, although the percentages of the local population engaged in these occupations did not differ from those in other NACDG cities. Equal percentages of workers in Kansas City and nationally had occupationally related allergy to glutaraldehyde, although the overall rate of glutaraldehyde was higher among patients from Kansas City. Most cases of relevant allergy to MCI/MI were cosmetically induced both in Kansas City and nationally.
The current findings show significant regional differences in causal allergens. The increased percentages of patients seen with ACD to formaldehyde, formaldehyde-releasing agents, and potassium dichromate in Kansas City were likely caused by the referral of greater numbers of work-related cases. However, occupationally acquired ACD to MCI/MI and glutaraldehyde were not more frequent in Kansas City than nationally, suggesting that other factors might be operative. Although awareness of national trends is important, dermatologists must be cognizant of regional variations in allergen sources within their communities and referral networks.
1994 - 1996年北美接触性皮炎研究组（NACDG）的斑贴试验结果，是自1970年NACDG成立以来首次纳入来自中西部一个中等规模大都市的结果。
本研究的目的是确定美国中西部过敏性接触性皮炎（ACD）的致病过敏原是否与美国其他地区不同，如果是，职业因素或其他因素是否能解释所观察到的差异。
对堪萨斯大学医学中心（堪萨斯城，堪萨斯州）收集的斑贴试验数据进行回顾性分析，并与其他NACDG中心收集的数据进行比较。
堪萨斯城的患者对重铬酸钾、甲醛及其释放剂、甲基氯异噻唑啉酮/甲基异噻唑啉酮（MCI/MI）和戊二醛发生反应的可能性在统计学上更高。堪萨斯城患者中职业性接触铬和甲醛的情况显著增加，尽管从事这些职业的当地人口百分比与其他NACDG城市并无差异。堪萨斯城和全国范围内对戊二醛有职业相关过敏的工人比例相同，尽管堪萨斯城患者中戊二醛过敏的总体发生率更高。在堪萨斯城和全国范围内，大多数对MCI/MI的相关过敏病例都是由化妆品引起的。
目前的研究结果显示了致病过敏原存在显著的地区差异。堪萨斯城ACD患者中对甲醛、甲醛释放剂和重铬酸钾的比例增加，可能是由于转诊了更多与工作相关的病例。然而，堪萨斯城职业性获得的对MCI/MI和戊二醛的ACD并不比全国更常见，这表明可能还有其他因素在起作用。尽管了解全国趋势很重要，但皮肤科医生必须认识到其所在社区和转诊网络中过敏原来源的地区差异。
